Homestead_Johnson (17) INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
D:-PREPARER -:.
Chris Sullivan Closer
Preparer of the Sales Disclosure Form Title
7820 Eagle Crest Blvd Ste 201 Regional Title Services
Address(Number and Street)
First Church of the Nazarene s, d
Seller 1-Name as appears on conveyance document Seller 1-Name as appears on conveyance document
601 S Lincoln St 601 S Lincoln St
Address(Number and Street) Address(Number and Street)
Fort Branch,IN 47648 Fort Branch,IN 47648
scare,and zip Code Stare,and cup Code
Telephone Number E-mail
Under penalties of perjury,I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct
and complete as required by law,and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act".
Signature of Seller Signature of Seller
First C urch of N ene Firs hunch of the ne
Bl' BYGeZee Gr�-
B olza „President I O �30 / Secretary n Q Ao
_Printed Name of Seller Sian D D/YYYYL ri ed Name ofSeller Sian ate I M/DD/YYYY1
t F:BUYER(S)%GRANlig(Si _APP N F LICATIbOR PROPERit7Fib lfil TT&WIDENTIFY la;lTEt6THAT APPLY_'` :.`,.,.- ,Z.:-fi W-: _.:.., i ;`;.
Matthew T.Johnson Molly Johnson
Buyer 1-Name as appears on conveyance document Buyer 2-Name as appears on conveyance document
94 Highland Road 94 Highland Road
Address(Number and Street) Address(Number and Street)
Sturgis,KY 42459 Sturgis,KY 42459
FILED
E-mail
Nov 02 2020
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY.IDENTIFY ALL OF THOSE THAT APPLY./y, _
YES NO CONDITION YES NO CONDITION ,IM��•',';'•�+�fy�+��
[[�❑ 1.Will this property be the buyer's primary ❑ 3.Homestead GIBSON COUNTY AUDITOR CB
residence? Provide complete address of primary ❑ Q 4.Solar Energy Heating/Cooling System
residence,including county: ❑ Q 5.Wind Power Device
600 S Center St
Address(Number and Street) ❑ El 6.Hydroelectric Power Device
Fort Branch,IN 47648 Gibson ❑ E( 7.Geothermal Energy Heating/Cooling Device
city,State ZIP ode county ❑ rri8.Is this property a residential rental property?
❑ 2.Does the buyer have a homestead in Indiana to be ❑ Q 9.Would you like to receive tax statements for this
vacated for this residence? If yes,provide property via e-mail?(Provide contact information
complete address of residence being vacated, below.Please see instructions for more information.
including county: Not available in all counties.)
Address(Number and Street) 2 6-19-19-101-000.618-02 6
Matthew T.Johnson Molly Johnson
City,State ZIP Code County Primary property owner contact name E-mail